2019年武汉儿童医院15 636例呼吸道感染儿童7项病毒检测结果分析

Analysis on seven virus detection results of 15636 children with respiratory tract infection in Wuhan Children's Hospital,2019

目的分析2019年1—12月武汉儿童医院住院患儿常见呼吸道病毒感染流行特征,为临床诊断治疗提供依据。方法采集2019年1—12月因呼吸道感染就诊的住院患儿鼻咽拭子标本,采用直接免疫荧光法对副流感病毒1、2、3型(PIV1、2、3型),流感病毒A、B型(FluA、B型),腺病毒(ADV),呼吸道合胞病毒(RSV)共7项呼吸道病毒抗原进行检测,并统计分析患儿的一般情况。结果2019年武汉儿童医院共收集15636份标本,7项呼吸道病毒的检出率为27.26%(4262/15636),RSV、ADV、PIV3型、FluB型、FluA型、PIV1型、PIV2型的阳性率分别是8.58%(1341/15636)、8.06%(1261/15636)、6.47%(1012/15636)、1.27%(198/15636)、1.20%(188/15636)、1.15%(181/15636)和0.83%(129/15636)。男性患儿的7项病毒总阳性率高于女性,差异有统计学意义(χ^(2)=21.031,P<0.001)。7项病毒中仅RSV的检出率男性高于女性,且差异有统计学意义(χ^(2)=12.442,P<0.001),其他病毒的检出率差异均无统计学意义(P>0.05)。6月龄至1岁及<6月龄患儿中病毒总检出率分别为33.85%(717/2118)、31.68%(1027/3242),差异无统计学意义(χ^(2)=2.760,P=0.097),但高于其他年龄组。7项病毒总检出率在春季最高,秋季最低。其中RSV在冬、春季检出率较高,PIV3型和ADV在夏、秋季检出率较高,存在明显季节性。其中混合感染48例,最常见混合感染病毒类型是PIV3型和RSV(50.00%,24/48)。结论7项病毒总检出率在武汉市不同性别、年龄、季节呼吸道感染患儿中存在差异,临床医生常规诊断中可以作为参考。

Objective To analyze the epidemiologic characteristics of common respiratory virus infection in hospitalized children in Wuhan Children's Hospital from January to December 2019,and provide evidence for clinical diagnosis and treatment.Methods Nasopharyngeal swabs were collected from the hospitalized children with respiratory infection from January to December 2019.Seven respiratory virus antigens of parainfluenza virus type 1,type 2,type 3(PIV1,2,3),influenza virus A,influenza virus B,adenovirus(ADV)and respiratory syncytial virus(RSV)were detected by direct immunofluorescence assay,and the general information of the children were collected and analyzed.Results A total of 15636 nasopharyngeal swabs were collected from the hospitalized children with respiratory infection in Wuhan Children's Hospital in 2019,and the total positive rate was 27.26%.The positive rates of RSV,ADV,PIV3,influenza virus B,influenza virus A,PIV1 and PIV2 were 8.58%(1341/15636),8.06%(1261/15636),6.47%(1012/15636),1.27%(198/15636),1.20%(188/15636),1.15%(181/15636),and 0.83%(129/15636),respectively.The positive rate of RSV was highest.The overall positive rate of seven viruses in boys was higher than that in girls,and the difference was significant(χ^(2)=21.031,P<0.001).Among the seven viruses,only the positive rate of RSV in boys was higher than that in girls,and the difference was significant(χ^(2)=12.442,P<0.001).There was no gender specific difference in the positive rate of other respiratory viruses(P>0.05).In all age groups,the detection rates in age groups 6 months-1 year and<6 months were 33.85%(717/2118)and 31.68%(1027/3242),respectively,which were significantly higher than those of other age groups.But there was no significant difference between age group<6 months and age group 6 months-1 year(χ^(2)=2.760,P=0.097).The overall positive rate was highest in spring and lowest in autumn,but the detection rate of RSV was higher in winter and spring.The detection rates of PIV3 and ADV were higher in summer and autumn with obvious seasonality.There were 48 cases of co-infections,and the most common coinfection type was PIV3 plus RSV,accounting for 50.00%(24/48).Conclusion The overall positive rate of the seven viruses in children with respiratory tract infection in 2019 varied with gender,age and season in Wuhan,to which physicians should paid attention in clinical diagnosis.